Objective:To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.Methods:This study was a prospective,randomized,controlled study.Sixty cases of calcaneal visual analogue scale (ASA)ⅠorⅡundergoing elective surgery were selected and randomly assigned to two groups,thirty cases in each group.The patients received popliteal fossa posterior tibial nerve block using ultrasound guided.The con-tinuous stimulation catheter was inserted after successful position and the 0.2%ropivacaine was injected. The background volumes of the A and B groups were 5 mL/h and 3.2 mL/h.The VAS score,the senso-ry block and motor block of tibial nerve and common peroneal nerve,and the satisfaction of the patients at h 12,h 24 and h 48 were recorded after catheter insertion.Results:The VAS scores at the three time points (h 12,h 24 and h 48)on the two groups of the patients were compared,and the difference was not statistically significant (P >0.05).The difference of the sensory block and the motor block of the tibial nerve at the three time points (h 12,h 24 and h 48)on the two groups of the patients were also compared,and the difference was not statistically significant (P>0.05).The difference of the sensory block and the motor block of common peroneal nerve at h 48 hs was statistically significant,group A was higher than the group B (P<0.05).The difference of the patient satisfaction at the three time points (h 12,h 24 and h 48)on the two groups was not statistically significant (P>0.05).Conclusion:The use of 0.2% ropivacaine with the background volume of 3.2 mL/h in continuous tibial nerve block can pro-vide good analgesia and reduce the incidence of the sensory block and motor block of the common perone-al nerve.

Adolescent ; Adult ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Orbit ; surgery ; Orbital Fractures ; surgery ; Otorhinolaryngologic Surgical Procedures ; Treatment Outcome ; Young Adult

Objective To report the results of the surgical treatment of cervical spondylotic myelopathy(CSM) secondary to athetoid cerebral palsy and clarify the characteristics and the principle of treatment of the disease. Methods The age of the patient, segments of vertabrae involved and operated upon, results and complications of 32 cases with CSM secondary to athetoid cerebral palsy were statistically analyzed and compared with 93 patients who had isolate CSM operatively treated at the same time. Results 1)The average age of the patients in the group of CSM secondary to athetoid cerebral palsy was 37.94 years,and in the group of isolate CSM was 52.48 years, with significant statistic difference(P

Objective To compare the reproducibility and reliability of facial soft tissue landmarks using a direct and an indirect placement methods in facial three-dimensional (3D) soft tissue assessment.Methods 3D coordinates of 37 soft tissue landmarks were obtained respectively in 35 normal healthy volunteers from 3D optical capture system and Materialise's interactive medical image control system (Mimics).Landmarks were affixed on the cutaneous surface (direct method) and marked on the 3D reconstructed craniofacial model (indirect method).Intra-class correlation coefficients (ICCs) and paired t-tests were used to compare the reliability and reproducibility of facial landmarks between two placement methods.Results For the direct placement method,86.5 ％ landmarks had an ICC higher than 0.75.For the indirect placement method,75.7％ landmarks had an ICC higher than 0.75.The inter-observer variability using the direct placement method was (1.259±0.566) mm,which was significantly smaller (P＜0.05) than (1.420±0.638) mm obtained by the indirect placement method.Conclusions Compared with indirect method,direct method has higher reliability and reproducibility in evaluating facial soft tissue.

Objective To describe an intelligent three-dimensional technique for automatic visualization of the fetal cranial mid-sagittal view to allow for the differential diagnosis of fetal midline anomalies.Methods Two hundred and twenty pregnant women with singleton pregnancies were imaged to display the mid-sagittal view of fetal head using a new 3D program (Smart MSP) developed by our team.Results The mid-sagittal view of the fetal head was successfully visualized in 190 normal cases (95％) and 18 abnormal cases (90％) by Smart MSP program.The total successful rate was 94.5％ (208/220).Conclusions Smart MSP is a novel and feasible method for the automatic visualization of fetal cranial midsagittal plane and may become a potential tool for routinely screening the fetal midline anomalies.

Objective:To observe and analyze the therapeutic effect and safety of tirofiban combined large dose statin in patients with acute myocardial infarction (AMI),and evaluate its influence on myocardial perfusion and cardiac function.Methods:A total of 97 consecutive AMI patients visited to our hospital from May 2011 to January 2013, who were beyond the emergency PCI time window (≥12h),their chest pain was remissive or not further aggravated were studied.All patients were pumped with tirofiban for 48h continuously;according to combined rosuvastatin dose,they were divided into large dose group (n = 52,20mg,once/d,until one month after infarction,then changed to routine dose of 10mg,once/d)and routine dose group (n=45,10mg,once/d).All patients received se-lective PCI after 7 ~ 10d conservative treatment.Myocardial perfusion level,left ventricular ejection fraction (LVEF)on one week after PCI and 30d after AMI,enzymology changes [creatine (CK),lactate dehydrogenase (LDH)]and major adverse cardiovascular events (MACE)during hospitalization were compared between two groups.Results:Compared with routine dose group,there were significant reductions in thrombus scores in infarct related artery (IRA)[(1.32±1.01)scores vs.(0.81±0.78)scores]and corrected TIMI frame [(32.4±4.73)vs. (26.8±2.34)]in large dose group (P =0.021,P <0.001);after selective PCI,TIMI flow of large dose group was significantly better than that of routine dose group (P =0.024).On one week after PCI,LVEF:(51.4±8.9)% of large dose group was significantly higher than that of routine dose group (47.7±8.7)%,P =0.021;there were no significant difference in levels of CK and LDH between two groups on 7d and 30d after PCI (P >0.05).There was no MACE in both groups during hospitalization and 30d after PCI.Conclusion:Tirofiban combined large dose statin is safe and effective in patients with acute myocardial infarction,it can reduce intra-coronary thrombus burden,im-prove myocardial tissue perfusion and cardiac function without increasing MACE.

Acute Disease ; Humans ; Male ; Middle Aged ; Thrombocytopenia ; chemically induced ; Tyrosine ; adverse effects ; analogs & derivatives

Medical postgraduates are the future core force of clinical diagnosis and treatment,scientific research,education and sanitary administration.Therefore,to cultivate qualified professionals,the key of contemporary medical postgraduate education is to pay more attention to comprehensive quality training in order to make students adapt to the continuous development of society and medical model.The First Clinical College in Wuhan University has implemented the hospital administration internship in combination with social needs and explored the education model of contemporary medical students with comprehensive quality.

Objective:To analyze the morbid risk factors of chronic tubulointerstitial nephropathy(CTN)with an unknown origin in Wenzhhou City.Method:810 residents in several big districts were investigated.652 subjects,which had complete data and were coincided with the inclusion standard,were analyzed by an unmatched case-control study.The case group contained 19 cases coincided with the diagnostic criteria for CTN with unknown causes.The controlled group contained 633 cases.Thirteen probable risk factors were selected to be investigated:age,sex,body height,body weight, occupation,education,allergic history,addiction to smoking or wine,family history,the respective exposure to heavy met- als,radioactive ray and poisons.A history of medications,including caulis aristolochiae manshuriensis,antipyretic analge- sic,antibiotics,etc.was also investigated.The odds ratio(OR)of CTN with an unknown origin caused by risk factors were calculated with Logistic regression analysis.The obtained data were investigated,and the risk factors were screened out. All the data were analyzed with SPSS 12.0.Result:The homogeneity test showed there was no significant difference in age, sex,occupation and education between the case and controlled groups.The exposure to heavy metals or caulis aristolochiae manshuriensis was screened as the valid risk factor of CTN with OR 17.50 and 103.594 respoetively(P

Objective To study the effectiveness of comprehensive control measures based on systematic ecological system construction to interrupt the transmission of schistosomiasis in hilly endemic regions in Sichuan Province ,so as to provide the ev?idence for adjustment of schistosomiasis prevention and control strategies. Methods A high endemic area of schistosomiasis, Panao Township of Dongpo District in Meishan City,was selected as a demonstration area. The comprehensive measures for schistosomiasis control with focus on systematic ecological management were implemented,and the income of residents,index?es of schistosomiasis control effect and so on were investigated before and after the intervention and the results were compared. Results The project based on systematic ecological system construction started in 2009 and 317.351 million Yuan was put into the construction. The construction included economic forest plant base(1 866.68 hm2,72.66%of the total farmland areas),eco?logical protection gardens(585.35 hm2)and so on. Totally 97.04% of historical areas with Oncomelania hupensis snails were comprehensively improved. In 2015,the peasants' pure income per capita increased 4 938 Yuan,with the average annual growth rate of 14.69%. All the farm cattle were replaced by the machine. The benefit rate of water improvement was increased by 52.84%and the coverage rate of harmless toilets increased by 18.30%. The positive rate of serological tests for schistosomiasis decreased from 7.69%to 3.50%,and the positive rate of parasitological tests decreased from 1.18%to 0. The area with snails was decreased from 23.33 hm2 to 0. The awareness rate of schistosomiasis control knowledge and correct behavior rate of the resi? dents increased from 85.50%and 82.60%to 95.70%and 93.90%respectively. Conclusions The comprehensive schistosomia?sis control measures based on systematic ecological management are conform to the currently actual schistosomiasis prevention and control work in hilly endemic regions,and have good ecological economic benefit and schistosomiasis control effectiveness, which provide an effectively new model of prevention and control for advancing process,consolidating the effect,finally realiz?ing goal of interruption and elimination of schistosomiasis in hilly endemic regions.